Effects of patient-level noise abatement orders on sound levels experienced by critically ill subarachnoid hemorrhage patients: an observational study

ABSTRACT

Background/Objective

Patients with aneurysmal subarachnoid hemorrhage (aSAH) may be at risk for complications related to excessive environmental noise. Our ICU utilizes a variety of universal interventions to minimize ambient noise levels, but patients with aSAH additionally have specific orders intended to further minimize physiologic stress and noise exposure. It is unknown whether such orders can have a supplementary reductive effect on noise exposure.

Methods

Sound levels were measured for at least three consecutive days in the rooms of 17 patients with aSAH and implemented ‘subarachnoid precautions’ orders. Sound levels were similarly recorded in the rooms of 11 geographically-proximate, critically-ill control patients without aSAH.

Results

Linear mixed models were used to assess the difference in measurements between groups. Observations were combined into fifteen-minute windows, then group means and their differences were calculated and plotted to help identify what times of the day had significant differences. aSAH patients consistently experienced lower sound levels than control patients, with a statistically significant difference (p < 0.05) in mean sound levels at 62 of 96 intervals throughout the day. Overall, the mean sound level for aSAH patients was always between 62–63dBA, while the mean sound level experienced by control patients ranged between 64–66dBA.

Conclusions

Implementation of patient-specific orders can have a supplementary reductive effect on noise exposure for aSAH patients in an intensive care unit that already utilizes universal noise abatement interventions.

KEYWORDS:

• Critical care
• critical illness
• noise
• subarachnoid precautions
• subarachnoid hemorrhage

Author’s contribution

Peacock, Amanda - Supervised the data collection, performed preliminary literature research, and wrote a preliminary draft of the manuscript.

Ten Eyck, Patrick - Performed statistical analysis, created plots, and helped edit the manuscript.

Sapp, Caitlin - Provided consultation on selection and use of dosimeters, reviewed and interpreted data, and helped edit the manuscript.

Allan, Lauren - Created graphics, performed literature search, and helped edit the manuscript.

Hasan, David - Reviewed and helped edit the manuscript.

Rogers, W Kirke - Primary author of the manuscript and performed primary literature research.

Acknowledgments

With thanks for Donna L Hammond for guidance, support, and statistical insight. This study was supported in part by the University of Iowa Institute for Clinical and Translational Science, which is granted with Clinical and Translational Science Award funds from the National Institutes of Health (UL1TR002537).

Declaration of interest

No potential conflict of interest was reported by the authors.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.